From cervical erosion to cancer. Manifestations, diagnosis, treatment

1. Causes
2. Symptoms
3. Types of uterine tumor
   Malignant
4. Benign
5. Stages of uterine cancer
6. Treatment
   Diagnostics
7. Therapy
8. Operation
9. Further development of the situation and forecast

A uterine tumor is a neoplasm that can be benign or malignant. A tumor is an overgrown tissue and localized in one or several places. Uncontrolled cell division in a tumor occurs under the influence of a number of factors.

Causes

A tumor of the uterus can occur for reasons such as hormonal imbalance, infections and inflammatory diseases of the pelvic organs, various injuries, and surgical interventions. The development of some types of neoplasms is influenced by hereditary predisposition.

The cause of tumors of the uterus and appendages is often a combination of unfavorable factors affecting the body: frequent stress, general fatigue and weakness, and chronic inflammatory processes in nearby organs (for example, the intestines) play a negative role.

The causes of cervical tumor formation are inflammatory diseases of the vagina, dysbacteriosis, dysbiosis. In many cases, disorders can occur when the synthesis of sex hormones changes. Cervical tumors caused by such causes as the presence of certain types of human papillomavirus in the body have an oncogenic risk.

To prevent the appearance of tumors, regular visits to the gynecologist are recommended. If there are no problems, you should see a doctor once every six months.

Symptoms

In women during menopause, the first symptoms that may indicate a tumor of the uterus may be:

• Lost menstrual cycle. Just before menopause, bloody discharge becomes less frequent and decreases in volume. But with a tumor, the discharge may become more frequent and abundant again.

In women after menopause, when there has been no menstruation for more than 2 months, symptoms may include:

• Any discharge with blood or bleeding.

In women of all ages, the following symptoms may indicate the presence of a uterine tumor:

• irregular bleeding;
• constipation;
• fast fatiguability.

The following types of pain may cause concern:

• in the lumbar region;
• lower abdomen;
• in the perineum;
• when urinating;
• after sexual intercourse.

Types of uterine tumor

Tumors can be benign or malignant. Benign tumors can develop for years without causing discomfort or danger to life. They are easy to treat. Malignant tumors (cancer) grow rapidly and can pose a serious threat to life. Treatment of such tumors is more successful the earlier they are diagnosed.

Malignant tumors

The classification of cancer depends on the location of the tumor in the uterus and the type of cancer cells:

• Squamous cell carcinoma
  is a tumor that develops from the epithelium of the cervical canal and the vaginal part of the cervix. The most common uterine cancer. Most often they get sick at the age of 30-34 years. The cause of this type of tumor is a virus. Its appearance is promoted by: smoking, early onset of sexual activity, frequent change of sexual partners, immunodeficiency states. Squamous cell carcinoma may be preceded by the following precancerous conditions: CIN I or moderate dysplasia;
• CIN II or severe dysplasia;
• CIN III or carcinoma.

Benign tumors

The most common benign tumors of the uterus are:

• A cyst
  is a bubble filled with liquid contents. The bubble itself is not dangerous and is rarely large, but it can cause complications in the form of pseudo-erosion on the mucous wall of the uterus or suppuration if it ruptures. To avoid complications, it is better to remove the cyst.
• Myoma
  is a ball of intertwined smooth muscle fibers of a round shape, with a diameter of several millimeters to several centimeters. It is more common during the late reproductive period and before menopause. It is the most common tumor in women. It is a hormone-dependent tumor. Occurs due to improper division of one smooth muscle cell. It is treated with medications such as tranexamic acid and gonadotropin releasing hormone antagonists. The most effective is surgical removal using laparoscopy, hysteroscopy and hysterectomy.
• A polyp
  is a tumor that is a growth from the basal layer of endometrioid cells. It is a tumor body on a stalk, with the help of which it is attached to the inner wall of the uterus. Occurs against a background of weak immunity and metabolic disorders. Most often occurs after the age of 30. Endometrial polyps are removed during hysteroscopy, and their base is scraped off with a curette. The procedure is carried out quickly under local anesthesia; after the operation, there may be bloody discharge from the uterine cavity for 10 days. Adenomatous polyps are a precancerous condition, so their treatment differs from the treatment of ordinary polyps. Women over 45 years of age with adenomatous polyps are prescribed complete removal of the uterus.
• Fibroma
  is a tumor that grows from the muscular layer of the uterus, which is dominated by connective elements. It is a hormone-dependent tumor. It grows from one mutated cell. It can be nodular or diffuse. Nodular fibroids are clearly defined and distinguishable from other formations, while the boundaries of diffuse fibroids are blurred and can merge with other formations.

Decoding the results

Oncologists diagnose cancer. The results of all completed examinations are always assessed in a comprehensive manner. The final diagnosis of uterine cancer is made only if there is morphological confirmation (verification). Based on the diagnostic findings obtained, the doctor plans treatment, makes a prognosis and gives his recommendations to the patient.

You cannot interpret the results of medical examinations on your own. This can lead to erroneous conclusions and wrong actions. The diagnosis of uterine cancer can only be made by a qualified gynecological oncologist.

At Euroonko, qualified gynecological oncologists deal with malignant neoplasms of the uterus. A set of methods is used to make a diagnosis, after which adequate treatment is prescribed according to modern standards. Thanks to the modern equipment of the clinic and extensive experience, we manage to achieve the best possible result in each case.

Book a consultation 24 hours a day
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Stages of uterine cancer

• Stage 0
  – a malignant change in the uterine epithelium without penetration of the basement membrane.
• Stage 1
  – the tumor is located within the body of the uterus.
• Stage 2
  – the tumor spreads to the cervix.
• Stage 3
  – the tumor metastasizes to the ovary, vagina, pelvic or para-aortic lymph nodes.
• Stage 4
  – the tumor spreads to the mucous membrane of the large intestine, bladder, distant organs and lymph nodes.

Treatment

Treatment of uterine cancer consists of accurate diagnosis of this disease, correct determination of the type of tumor and, based on diagnostic data, the choice of treatment method - therapy and surgery.

Diagnostics

To identify the disease and determine the type of tumor, the following methods can be chosen:

• Clinical diagnosis
  - patient interview, gynecological examination and medical history.
• Ultrasound examination of the pelvic organs (ultrasound)
  is a research method using an ultrasound machine that allows you to identify a tumor, study its size and structure, check the condition of the outer, mucous and muscular layer of the uterus, assess the state of blood flow and detect lesions in other organs.
• Hysteroscopy
  is a visual examination of the uterus and collection of biological material from the inner layer in places where a tumor is suspected.
• The cytological method
  is the study of the cellular composition of the material obtained as a result of smears during a gynecological examination. Based on the cellular composition, one can determine the presence of an inflammatory process, atypical and cancer cells in the uterus.
• Biopsy and immunohistochemistry
  - examination of uterine material taken using a colposcope, under a microscope and using immunohistochemistry to determine the type of tumor cells.
• Histological examination
  - examination of material taken from the uterus under a microscope. The structure of the tissue, the presence of tumor cells and their differentiation are studied.
• Tumor marker CA-125
  is a blood test for the presence of markers that indirectly indicate the spread of the tumor process in the body.
• Fluorescent diagnostics
  is a method in which photosensitizing substances that can selectively accumulate in malignant cells are introduced into the body. Then, using an endoscopic examination of the uterus, the location of the tumors is identified. The method allows tumors of less than 1 millimeter.

After receiving data collected by various methods, the doctor deciphers the results, evaluates everything in its entirety, makes a diagnosis and prescribes treatment.

Therapy

For certain types of tumors, treatment may be effective:

• Hormone therapy
  is the use of hormones, such as progesterone and others, to suppress certain types of tumors in the early stages. It is most often used to treat women who are planning to become pregnant in the future. Weight gain and other side effects may occur after hormone therapy.
• Chemotherapy
  is the use of chemicals that destroy certain types of tumors. Typically used after surgery to destroy remaining cancer cells in the body. Therapy is carried out in intravenous cycles. As side effects, it can cause hair loss, disturbances in the gastrointestinal tract, and decreased immunity.
• Radiation therapy
  is used to destroy cancer cells, either alone or in combination with other types of therapy and surgery. Irradiation of the tumor can be external or internal. External radiation is done using a large machine that directs rays from the outside to the site of the tumor in the uterus. Internal irradiation is carried out by inserting a cylinder containing radioactive material into the vagina for a short time. Radiation therapy may temporarily cause menstrual irregularities, vaginal tightness, burning, dryness, and irritation.

The use of therapy depends on the type of tumor, stage of development, general health of the patient, his age and many other factors.

Operation

The main method of treating the disease by removing the tumor:

• Conventional abdominal surgery (laparotomy)
  . To access the tumor and remove it, a large incision is made in the abdomen.
• Endoscopic surgery
  . The tumor is removed using an endoscopic device, which is inserted through several small incisions in the anterior abdominal wall.

The surgical method is chosen by the surgeon depending on the patient’s condition.

You can make an appointment for diagnosis and treatment of a uterine tumor at our L-Med clinic by calling +7

or through the online form on the website.

Cytological method

To detect cervical cancer, cytological analysis is of great importance. The essence of the method is to study the cellular composition of the resulting material. Cytology smears are part of the standard gynecological examination for diseases of the uterus.

Clinicians use the Pap test to:

• 1st class - there are no atypical cells, a normal cytological picture is observed;
• 2nd class - there are inflammatory changes;
• 3rd class - there are single cells with a change in the ratio of cytoplasm and nucleus, the result is unclear, so repeat cytology is performed after some time or a biopsy specimen is taken from the cervical part of the uterus for histological study;
• 4th class - there are single atypical cellular elements in which signs of malignancy are observed (uneven arrangement of chromatin, huge nuclei, etc.);
• Grade 5 - there are many malignant cells present in the smear.

When receiving an aspirate from the uterine cavity, a cytological examination of the obtained material is also carried out. If numerous malignant cells are detected, a diagnosis of cancer is made.

Further development of the situation and forecast

The prognosis for recovery depends on many factors, such as the patient’s age, type of tumor, stage of cancer, presence of metastasis, and others. Patients under 50 years of age have a more favorable prognosis with a hormone-dependent type of cancer and the absence of metastases. The prognosis is worse for women over 70 years of age with a type of cancer that is insensitive to hormones. Detecting and treating cancer at an earlier stage provides a better prognosis. Treatment of endometrial cancer gives better results than sarcoma. Removing a small, localized tumor provides a more favorable prognosis than a large tumor that has spread to other organs.

All patients who have been diagnosed with uterine cancer and who have undergone treatment are under the supervision of a gynecological oncologist.
Women who have received treatment for uterine cancer with preservation of the organ may become pregnant after hormonal rehabilitation and restoration of ovulatory cycles. In these individuals, pregnancy management requires special attention. Patients who have undergone complete amputation of the uterus may develop posthysterectomy syndrome. All articles "

— Does HPV manifest itself as dysplasia at the initial stage? How is it treated?

— Yes, dysplasia of the first degree appears first, and then the second and third degrees. First degree dysplasia can heal on its own, or it can progress to the second degree. The second degree can also self-heal, that is, flow into the first or, conversely, worsen, moving into the third degree. The most difficult, third degree, very rarely heals itself, and in this case surgical intervention is necessary. The doctor performs a therapeutic and diagnostic operation (electroconization) and excises the affected part of the tissue.

After this minor surgical intervention, the body recovers, and the excised area is sent for histological examination. After it, it becomes known whether it is dysplasia or whether an area larger than dysplasia has already appeared there, for example, stage zero cancer. As a rule, 95% of third-degree dysplasia requires surgical treatment, that is, excision.

— Do the first and second degrees of dysplasia require surgical intervention?

- The first and second degrees can be treated conservatively and excised only if it is combined with ectropion, polyps or ectopic epithelium.